Late Rent Payments Can Harm Health Outcomes of Caregivers and Children

Unstable housing, which includes poor housing quality, unstable neighborhoods, overcrowding, and other factors, is a significant social determinant of health for adults and children. This new study identified three forms of housing instability (being behind on rent, moving multiple times, and experiencing homelessness) associated with inadequate access to care and poor health outcomes; sought to determine their associations with caregiver and child health in household; and examined whether there was overlap between the three housing circumstances. The study used data from Children’s HealthWatch household-level surveys and medical record audits from 2009 to 2015 in primary care clinics and pediatric emergency departments, and the sample included 22,324 low-income renter households with children ages 4 and younger. The authors conducted multivariable logistic regressions to determine associations between health outcomes and each form of housing instability measured. Each of the housing circumstances was associated with adverse health outcomes for caregivers and children. The findings have policy implications for pediatricians.

Key findings

• Thirty-four percent of families surveyed had at least one of the three adverse housing circumstances; 27 percent had been behind on rent, 8 percent had multiple moves, and 12 percent had a history of being homeless.
• Each form of housing instability was associated with adverse health outcomes for caregivers and children and with material hardship.
• The three housing circumstances have little overlap. Each is important for determining risk for poor health status and material hardship among renting families with young children.
• In addition to standard health care screening questions, pediatricians should consider asking caregivers about being behind on rent and their history of moves and homelessness.